Muchor
®
MANUAL
Dyna Dental Engineering BV, Halsteren, the Netherlands has implemented and maintains a quality management system for the following field of activities: develop-ment, manufacturer and sale of dental implants and medical devices for dental restorations. Dyna Dental Engineering B.V. is ISO 13485 certified.
Warning The descriptions given in this enclosure are insufficient to allow immediate use of all Dyna Implant Systems. Guidance in the handling of the Dyna Helix® ART
Octalock® Implant System and Dyna (Octalock®) Implant System by an experienced operator is strongly recommended. Dyna Helix® ART Octalock® and Dyna (Octalock®)
Implant Systems must only be used by properly trained dentists/doctors and in combination with original components. In case of multiple use the following dangers could occur: cross infection, damaging products and as a result their function, wrong identifications of products. For more detailed information please refer to the Dyna Implant Manuals as well as Dyna Terms of Guarantee – available on request. With the publication of this instructions for use all previous are no longer valid.
Content package
See label on packaging.
Precautions
When damaged exchange attachments immediately. Do not grind or sandblast. Improper technique can contribute to implant/prosthesis failure and/or bone loss. Check the overdenture/attachments regularly (every 6 months). Use only the original instruments. Denture cleaning agents should be used with care. Overnight cleaning so-lutions should be avoided. Implant mobility, bone loss, infection may be the symptoms of implant failure. Magnets may not be heated above 120°C / 248°F and only be used in combination with Dyna EFM alloy, Dyna Keepers and Dyna Medical(magnet) abutments. Denture without balanced occlusion and articulation will contribute to failure. Minimally use 8 Muchor® anchors in the dorsal area. In very small maxilla 6 Muchor® anchors can be indicated to prevent placement in the front area. Anchors
may not be altered in any way. Use all Dyna Magnet Bond products in a well ventilated place and keep away from ignition sources. Do not inhale vapour. Do not empty into drains. Use suitable gloves. Usually the DYNA Magnet Bond does not cause any irritation to the skin, but contact with injured skin must be prevented. See Product Safety Data Sheets for more information. In case of any doubts concerning the use of Dyna products contact Dyna Dental Engineering BV or your local dealer.
Complications
Possible complications, related to prosthetic rehabilitation with dental implants, include:
inflammation, bone loss, (chronic) pain, patient discomfort, tissue degeneration, bone/implant/restoration fracture, implant/suprastructure mobility. In case of compli-cations follow the specific for the particular situation, appropriate course of actions-for more details see the Dyna Implant Manual.
Please note:
It is the user of Dyna products who is obliged to determine whether or not any products are suitable for a particular clinical situation. It is the user of Dyna products who is obliged to document in appropriate manner the products used for each patient. Dyna Dental Engineering BV disclaims any liability, express or implied and shall not be responsible for any damages arising from or in connection with any errors in professional judgement or practice in the use or installation of Dyna products. It is the users duty to study the latest developments in dental implantology as well as Dyna Implant Systems and its applications. When using our product intra-orally take proper care to prevent them from being inhaled or ingested.
Handling and Storage
Store in clean, dry, dust-free, dark room at room temperature. Store Magnet bond products cool, in well ventilated, dry, dark room and make sure bottles are closed.
Delivery
Federal law restricts these devices to sale by or on the order of a dentist or a physician.
Traceability of serial/lot numbers
It is the end users responsibility by law to record the serial and/or lot numbers of all products for traceability purposes.
Training
Dyna Dental Engineering BV arranges regular training courses for the beginning and advanced implantologists. The courses are obligatory and are meant to provide the Dyna user with practical and theoretical expertise concerning the use of Dyna Implant System, Dyna (Direct) System and Muchor® Mucosal anchorage system.
Copyright and trademarks
All Dyna documents may not be copied, reprinted or published in whole or in part without the written authorization of Dyna Dental Engineering BV. Dyna®, Muchor®,
Dyna Octalock®, Instant Adjusting Bar® and Dyna Helix® are registered trademarks of Dyna Dental Engineering BV.
Explanation Symbols
Catalogue number, article code Serial number
Batch code Manufacturer
Attention, read instructions for use Single use only - do not reuse SN
LOT
Dyna Dental Engineering B.V. Vang 9 4661 TX Halsteren The Netherlands Tel.+31 164258980 Fax.+31 164 258390 E-mail: dyna@dynadental.com REF
General Information
1. Introduction
4
2. (Contra)Indications
5
3. Why use Muchor
6
4. History and scientific background
7
5. Technical and biological infomation
8 - 9
6. References and literature
10
7. Components
11
8. Clinical Procedures
12 - 16
9. Night guard
17
10. Rebase Procedure
18
11. Instuctions for the patient
19
12. Opening instuctions
20
The use of dental implants has become a scientifically accepted treatment concept to replace missing elements of the dental arch. The range of possible implant applications is wide and gives the clinician a chance to plan full rehabilitation of the mouth. The use of implants in combination with different barrier membranes has undoubtedly changed dentistry in the past few years but, due to the uncertain outcome, many clinicians are still not sure of their use. Also, not every patient is willing to undergo such extensive treatment. Various limitations made us look for other possible solutions that could be used for retaining dentures in the mouth.
This manual presents an alternative technique to simply provide the patient wearing partial or full upper dentures with bet-ter retention and stabilisation. It presents basic information concerning surgical and prosthetic procedures accompanied by practical tips for both the dentist and the dental technician.
We can imagine that some questions may be left unanswered after reading this manual. For this reason, and in view of the extremely fast changes in dental market, we recommend attending lectures, and reading the available scientific publi-cations appearing in dental magazines and books. To acquire, on the other hand, indispensable practical skills we strongly advise attending one of the courses, given by experienced specialists keen to share their knowledge with you, organized by Dyna Dental Engineering BV.
In case of any questions you can always visit our website www.dynadental.com or contact us directly on the telephone number +31 164 258980 Fax +31 164 258390 E-mail dyna@dynadental.com.
Muchor® can be defined as an attachment-like retention system designed to be fixed to the denture to increase its reten-tion and stabilizareten-tion. It consists of ceramic elements (Ytrium stabilized zirconium oxide), more or less elliptical in cross section, that act as intra-mucosal anchors.
INDICATIONS
Its primary indication is to achieve retention and stabilisation for an upper denture. Especially Muchor® mucosal anchors can also be indicated for patients normally using a denture adhesive. Muchor® mucosal anchors can additionally be an option in those situations where implant indications are limited and/or financially not pos-sible. Due to its simplicity and efficiency there are many diverse indications (for the Maxilla):
implant contra-indications •
cleft palate •
vestibule that can not be operated •
atrophic upper jaw •
hyper gag reflex patients •
epitheses constructions •
CONTRA INDICATIONS
All contraindications associated with elective oral surgery should be noticed. The scope for the use of Muchor® depends on the particular clinical case and can be
modi-fied or adjusted to the individual patient’s situation. It is therefore important to judge every case thoroughly and take into consideration the following contraindications:
denture without balanced occlusion and articulation •
mucosa thickness less than 2 mm • haemophilia • flabby ridge • diabetes mellitus •
lack of motivation to perform adequate hygiene •
acute or chronic leukaemia •
patients using anti coagulants •
limitation deriving from anatomy of the jaw •
severe hypertension •
very recent myocardial •
HIV virus •
infractions •
In most cases, it is the severity of the condition and the patient’s residual ability to tolerate treatments that determine whether or not any therapy is contraindicated. In addition, there are a number of systemic medical conditions that can
cause complications during the healing stage, and may contribute to treatment failure. These factors must also be assessed by the operator.
In some situations the application of conventional prosthetic restorations is limited. This can be related to medical, clinical and/or financial limitations, fear for treatment, or a combination of these factors. Therefore, there is a constant need to offer the den-tists and their patients a system that is a simple and predictable solution to retention problems.
It is well known that most of the patients experience little or no problems with the function of their upper dentures. This fact, combined with the simplicity of the treat-ment itself, makes dentists offer this particular solution routinely. Minor complaints of patients are compensated by other factors such as price and patient acceptance. However, this does not mean that they have no wishes concerning their prostheses. It is striking how many patients ask about implants even though they can function well with their dentures. Most of them, if asked whether they would like to have the same denture but without a palate, would give a positive answer. This could also be extended to questions about retention and stability, chewing efficiency, comfort, or aesthetics. Such small changes made in a simple and inexpensive manner would certainly please all patients wearing dentures.
Muchor® is such a system. It is easy, economic and predictable; it gives a clinician the possibility to offer his patients an acceptable solution when extra retention and stabilization is needed.The treatment is safe as it is reversible. If the treatment is not satisfactory to the patient for what ever reason, the anchors can easily be removed. The sites in the mucosa will be closed within a few days to a few weeks.
Minimally use 8 Muchor® anchors in the dorsal area. In very small maxilla 6 Muchor® anchors can be indicated to prevent placement in the front area.
The idea of intramucosal inserts (“Muchor®”) is not new in dentistry. The first reports came from Dahl and Nordgren from 1942 1 ,who described a technique of forcing the inserts into the mucosa and fixing them into the prosthesis. Nordgren reported 30 cases successfully functioning for a period of up to 10 years2. This technique, though effective, was compli-cated and uncomfortable.
In 1953 Lew and Kersenbaum described a modified technique for “an implant button” for edentulous patients. It was based on the fixing of metal male parts into the prosthesis and, after transferring the position to the mouth and cross incising of the mucosa, inserting and pressing the prosthesis into place2. They noted, however, the necessity to adjust the size of the inserts as well as the appropriate technique.
In 1958 Cranin and Cranin proposed a technique using two different sizes of elliptical in cross section inserts of 2.0mm and 2.5mm made out of “non reactive metal”. They were first determining the proper position for the inserts in the mouth and then transferring it into prosthesis. The technique allowed for using a trephine drill to create space in the mucosa and, if necessary, deepening the trephined receptor site by entering the cortical plate of bone with round drill.3
In 1961 the same authors described a modified technique using adjusted instruments and inserts. They also pro-posed other uses of the inserts (partial maxillary dentures, enabling clasp-less partial dentures, intermaxillary elastic hook in orthodontics or fractured dentures).12
Dhal in 1966 stated “…intramucosal inserts based on clinical use during more than 25 years offer a reliable retention for upper dentures…”
In 1973 Weiss and Judy introduced a newly designed mucosal insert that proved more satisfactory because of the precision design of the insertion burs and insert, and the refinement of their placement into the prosthesis.4 Babbush in 1976 wrote “ modification of design and fabrication of precision insertion instruments for mucosal inserts have made this a useful procedure for patients with denture retention problems”
In 1982 Misch described the inserts as “mushroom shaped projections which are attached to the tissue bearing surface of a maxillary removable denture prosthesis”. He stressed the role of the inserts in preventing the need of regular relining of the dentures, and the fact that there has never been reported evidence of dysplastic changes in the epithelium around an intramucosal insert. The technique described used modified metal inserts as well as two tissue drills.
The Muchor® anchors are made out of zirconium oxide (ZrO2,Y2O3 Ytrium stabi-lized). This material is well known for its outstanding mechanical properties for use in implantology. It is highly biocompatible, extremely hard and resistant to scratching 18, 19, 20, 21, 22. Because of the fact that Zirconium oxide ceramics can be polished like glass or porcelain, the bacteria and plaque formation on its surface is significantly minimized. The shape of the anchors has been designed so that the mucosa could easily adapt itself around the Muchor® anchors. In this way the living tissue would act like a matrix for a ball attachment.
Cell growth on the Muchor®
zirconium oxide anchors SEM magnification 1000 x
Histological findings by observing biopsies of the oral mucosa around Muchor® anchors did not change by comparing cuts done after 6 months, 2 and 3 years of denture use.
The histological picture shows the cronic response of long period, probably due to the loading and stress distributed on the epithelium. In this case the epithelium presented the increase of parakeratinization, hyperplasia (epithelium layers became thicker), and acanthosis (flatten epithelium crests). The described acanthosis and hyperkeratinezed layer are common fin-dings in the mucosa of denture users.
Contact with Muchor Anchor
Hyperkeratinezed layer
Epithelium
Papillae
Lamina Propia
Regarding the histological findings the following summery of the results can be given:
Oral mucosa: Observe epithelium and lamina propria
Epithelium covers the connective tissue in contact with the Muchor® anchors No change was found in the epithelium in contact with Muchor® anchors Presence of hyperkeratinized layer produced by the epithelium cells facing a chronic irritation (epithelium protection) which is a common finding under nor-mal dentures
Acanthosis: epithelium layer becomes thicker
No evidence of dysplasia concerning the Muchor® an chors procedures, related in the international literature
Lamina propria Epithelium layer
5. Technical and Biological information
Ø 3,20 mm
Ø 4,40 mm
Literature:
Lew I., Kersenbaum I. “An Implant Button Technique for Denture Prosthesis” Dental Digest 59:298 July, 1953 1.
Cranin A.N., Cranin S.L “The intramucosal insert: a method of maxillary denture stabilization” The Journal of Ameri-2.
can Dental Association 57:188 August, 1958
Cranin A.N., Cranin S.L.“The intramucosal insert: review and progress report” J.A.D.A. 62:658 June, 1961 3.
Judy KW, Weiss CM. Intramucosal inserts: conserve edentulous ridges and increase retention and stability of remo-4.
vable maxillary prostheses. Oral Implantol. 1973 Autumn;4(2):179-204.
Babbush C.A. “Mucosal inserts: a technique for the atrophic alveolar ridge” J Oral Surg. 34:517 June, 1976 5.
Misch C.E. “An Improved Design and Technique for Mucosal Inserts” J.of Oral Impl. 1982;10(1):41-54. 6.
Guaccio R.A. “Intramucosal Inserts for Retention of Removable Maxillary Prosthesis” Dental Clinics of North Ame-7.
rica 24:585 July,1980
Weiss CM, Judy KW. Intramucosal implantation may solve upper denture problems. 1 Quintessenz. 1975 8.
Nov;26(11):13-9 contd. German.
Weiss CM, Judy KW. Intramucosal implantation may solve upper denture problems. II Quintessenz. 1975 9.
Dec;26(12):15-22. German.
Judy KW, Weiss CM. Atypical maxillary prosthodontic problems solved with intramucosal inserts--I. Oral Implantol. 10.
1975;6(2):210-21.
Judy KW, Weiss CM. Intramucosal inserts.Oral Health. 1973 Nov;63(11):12-8. 11.
Dahl GS. Some aspects of the use of intramucosal inserts. J Oral Implant Transplant Surg.1966;12:61-5. 12.
Dahl GS. Some aspects on the use of mucosal inserts Sven Tandlak Tidskr. 1965 Oct 15;58(10):523-30. 13.
Massimei GG. Template construction for accurate placement of intra-mucosal inserts. 14.
Implantologist. 1978 Aug;1(3):103-11.
Evasic RW. Intramucosal inserts for mandibular prostheses. Basic technique. Implantologist. 1978 Aug;1(3):39-47. 15.
Misch CE. An improved design and technique for mucosal inserts. Implantologist. 1981;2(2):39-47. 16.
Evasic RW. Intramucosal implants. A review of concepts and techniques. Single inserts and tandem denserts. J Oral 17.
Implantol. 1982;10(1):9-23.
Schultze-Mosgau S. et al. “Osseointegration of endodontic endosseous cones: zirconium oxide vs. titanium “ Oral 18.
Surg Oral Med Oral Pathol Oral Radiol Endod 2000 Jan;89 (1):91-8
Akagawa Y et al. “Comparison between freestanding and tooth-connected partially stabilized zirconia implants after 19.
two years of functions in monkeys” J Prosthet Dent 1999 Nov;80(5):551-8
Covacci V et al “In vitro evaluation of the mutagenic and carcinogenic power of high purity zirconia ceramic” Bioma-20.
terials 1999 Feb;20(4):371-6
Lee JC et al Gut “Absence of skin sensitivity to oxides of aluminium, silicone, titanium or 21.
zirconium in patients with Crohn’s disease” 1996 Aug;39(2):231-3
Chapman & Hall by J. Black and G. Hastings “Oxide bioceramics: inert ceramic materials
22. in medicine and dentistry”
J. Li and G.W. Hastings. “Handbook of Biomaterial Properties” 1999
MuChOR® ANChORS
Muchor® anchor 8pcs 91MA8
MuChOR® DRIllS
Muchor® laboratory drill 91ML1
Muchor® dentist drill 91MD1
MuChOR® SeTS
The Muchor® system set will be delivered in one package including:
8 Muchor® anchors
1 Muchor® dentist drill Ø 3,7mm 1 Muchor® laboratory drill Ø 4,7mm
Muchor® set complete incl. drills 91MS1
MuChOR® AuxIlIARIeS
Muchor® Marker Holder 92EL1 Muchor® Marker Tips (8pcs) 92LT8
The use of Muchor® system will be shown using simple examples of basic indications for this type of Anchorage system. Muchor® is mainly indicated for improving reten-tion and stabilizareten-tion of full upper dentures. The idea of its funcreten-tion is based on the natural healing process of the mucosa. The technical procedure for making a denture with Muchor® anchors resembles that of a full denture, which makes it suitable for all practitioners. Nevertheless, every case should be treated with adequate care and responsibility. Careful examination and detailed planning is necessary to avoid any disappointments. Attention should be paid to the contraindications (see page 5) and if necessary patient should be adequately prepared.
USING THE MUCHOR® SYSTEM IT IS OF PRIMAIRY IMPORTANCE TO
PRODUCE DENTURES WITH A BALANCED OCCLUSION AND ARTICULATION
Muchor® anchors can be fixed either in a new or in an already existing denture. This procedure can be combined with a rebase procedure or performed by the dentist chair-side. The chair-side procedure is faster and saves time for the patient, whereas, all lab-involved methods increase the precision and durability of the work.
Using the Muchor® system can be divided into four steps: 1 Production of the denture
2 Fixing the 8 Muchor® anchors into the denture base 3 Preparation of the Muchor® sites, in the mucosa 4 Healing
The example on the next page shows the application of the Muchor® system in an existing full upper denture with a balanced occlusion and articulation with retention problems.
In the case of producing a new denture, the normal procedures for a full denture case should follow first. A wear-in period to detect any problems with the denture is a must. Only after solving them can the Muchor® system be used.
FIRST AppOINTMeNT
This appointment is intended to gather all the necessary medical data needed to proceed with the desired treatment, and give the patient all the information about the denture- its advantages, time-planning etc.. The following factors should be taken into consideration:
Medical status •
Analysing X-ray photos •
Intraoral inspection (measurement of the mucosa thickness) •
Planning. Any additional treatment should be planned and discussed with the patient •
DENTIST
Measure the mucosa thickness. Search the mucosa areas with a thickness of minimal 2,5mm. The ideal thickness of the mucosa is approximately 3,75mm. Drilling into the bone to provide sufficient space for the Muchor® anchor is possible. There must be around 1mm space on top of the anchor. Consequently a X-ray examination (OPG) is a must (anatomy).
The measurements may be taken ultrasonically or with a sharp injection needle with an endodontic stop. (This technique resembles bonemapping in implant surgery procedures) Mark the ideal 8 Muchor® anchor positions with the Muchor® Marker on the acrylic of the denture
LABORATORY
Prepare the sites for the fixation of the Muchor® anchors in the marked places with the Muchor® laboratory drill.
It is recommended that a surveyor is used in order to assure the proper path of insertion.
Verify the preparations and fix the anchors with e.g. self or light curing resin.
Remove the excess of the resin and polish the sites carefully with small polishing instru-ments.
NOTE:
FIxING THE 8 MUCHOR® ANCHORS CAN ALSO BE CARRIED OUT AS A CHAIR-SIDE PROCEDURE. HOWEVER THE LABORATORY METHOD INCREASES THE PRECISION AND DURABILITY OF THE WORk.
NOTE:
INSERT THE 8 MUCHOR® ANCHORS AS PARALLEL AS POSSIBLE.
To assure a perfect position of the Muchor® anchors intraorally a drilling guide is re-quired. This drilling guide can be used later as a night guard. (see paragraph 3.3). Cover the head of the Muchor® anchors in the denture with putty material (e.g. Gingif-ast®) and make a putty or plaster model.
Put the model under the vacuum forming machine.
Heat the vacuum forming plate and draw the plate over the model. Take off the plate and fi nish the outline
NOTE
:
ALTHOUGH THE SURGICAL PROCEDURE FOR THE MUCHOR
®SYSTEM IS VERY
SIM-PLE IT SHOULD NOT BE UNDERESTIMATED. SURGERY SHOULD COMPLY WITH ALL
REqUIREMENTS FOR THIS TYPE OF PROCEDURES AND ALL NEEDED INSTRUMENTS
BE PROPERLY STERILIzED. TO PREVENT CONTACT BETWEEN THE MUCHOR
®AN-CHORS AND THE PERIOSTIUM ONE WOULD BE FORCED TO DRILL INTO THE BONE
PROVIDED THAT ALL ANATOMICAL ASPECTS (E.G. SINUS MAxILLARIS) HAVE BEEN
TAkEN INTO CONSIDERATION.
Use a diamond drill to make the initial preparation sites.
Make the final preparations with the Muchor® dentist drill. The length of the drill is equal to the depth of the preparation sight.
In case of doubt regarding the fit of the denture the preparations can be checked with a Muchor® anchor.
SeCOND AppOINTMeNT DENTIST
Place the drilling guide in the mouth and verify the fit
Anaesthetise the areas where the mucosa anchors are going to be placed. One cartridge is more than enough to achieve adequate
an-aesthesia. Large quantities could disturb the denture inser-tion.
Insert the denture firmly; check the fit, the occlusion and articulation. Patient should not remove the denture for the first 72 hours. Inform the patient about the importance of keeping the denture in place and that smoking is not allowed during the healing period. Prescribe painkillers. Rinse with chlorhexidine twice a day.
To increase the stability and retention during the healing period a dental adhesive should be used.
After the 72 hours of healing it is recommended to use a night guard during the night. Send the putty model with the drilling guide to the laboratory to change the drilling guide into a night guard. (See paragraph 3.3)
ThIRD AppOINTMeNT
After 72 hours see the patient and take out the denture. Check the fit, remove the pres-sure points if necessary and give further instructions. We recommend seeing the patient again after three days and further appointments when necessary. Healing of the mucosa takes around two weeks in normal conditions.
The denture should be in place day and night until complete healing has taken place, though the patient should take out the denture every day and clean it properly. At night the night guard can be used.
Special gels containing pain-killer and Chlorhexidine (e.g. corsodylgel 9,0 with 2% xylo-cain) may be applied in and around anchors before reinserting the denture. Instillagel® is a brand which could be used. The patient should also use chlorhexidine mouth washes. If needed additional pain killers may be prescribed. No antibiotics are necessary unless there is severe infection.
A “night guard” is recommended. The night guard is a sort of thin plate with reduced palate provided with Muchor® anchors in positions that correspond to the ones in the denture. It is designed to be worn at night or in cases when the patient can not wear the prosthesis as a result of e.g. mucositis or when the denture is under repair.
TeChNICAl pROCeDuRe WheN NO DRIllINg guIDe WAS uSeD:
The procedure described below is only an example of the technique showing the general idea of the production of a night guard. Our goal is to present technical details to help the technician as much as possible.
Cover the head of the Muchor
1. ® anchors with a putty material (e.g. Gingifast®).
By placing some metal anchors in the elastic material before 2.
hardening, you will enhance the connection to the putty. Make a putty model of the denture
3.
Separate the putty model 4.
Place new Muchor
5. ® anchors into the Gingifast® parts of the putty model
Put the model into the vacuum forming machine. Heat the vacuum 6.
forming plate and draw the plate down over the model Take off the plate and fi nish the perifery
7.
Put the anchors back in the model; make little holes in the plate 8.
at the position of the anchors and fi x with self curing resin Let the acrylic cure; remove the excess of the acrylic 9.
Polish and fi nish the night guard and send it to the dentist 10.
Night guard in the patients mouth. 11.
9. Night guard
5 6 8 7 9 10 11 1 3. 2 6. 4 3ReBASe pROCeDuRe
Judy and Weiss have published in the Journal of Oral Implantology that intramucosal inserts conserve edentulous ridges and increase retention and stability of removable maxillary prostheses5. During the 5 year clinical evaluation Muchor® mucosal anchors no rebase procedures were indicated.
However in the event a rebase procedure is indicated, the following procedure can be used. DENTIST
Make an impression as usual with the Muchor® anchors in place. Inject the impression material (light body) around the anchors, take the impression and send it to the laboratory.
NOTE:
IF THE MUCHOR
®ANCHORS ARE FULLY COVERED BY A LAYER OF IMPRESSION MATERIAL IT CAN MEAN THAT THE
SIGHTS IN THE MUCOSA ARE TOO LARGE. IN THIS CASE THE TOTAL CLINICAL AND LABORATORY PROCEDURE
MUST BE DONE AGAIN. REMOVE THE MUCHOR
®ANCHORS FROM THE DENTURE AND FILL THE HOLES WITH A
COLD CURE RESIN AND GIVE THE DENTURE TO THE PATIENT.
AFTER TWO WEEkS MAkE THE REBASE IMPRESSION AND SEND IT TO THE LABORATORY.
THE LABORATORY CAN NOW START THE PROCEDURE AS DESCRIBED IN THE MANUAL.
Cover the head of the Muchor® anchors with hard body silicone mate-rial. By placing some metal anchors in the elastic material before har-dening you will enhance the connection to the plaster. Than pour out in stone and proceed with normal hot cure or cold cure rebase procedure.
After removing the denture from the model the Muchor® anchors are removed from the denture. This can be done easily by heating the acry-lic (gradually!) around the anchors. Remove heated acryacry-lic and prepare the denture as normal.
Replace the Muchor® anchors in the model and proceed with the rebase procedure as normal. Finish the denture and send it to the dentist.
Dentist can now place the denture and check the occlusion and articu-lation! Check the denture after a week on pressure points, occlusion and articulation.
AFTeR SuRgeRy:
Do not take out the denture for the first 72 hours after placement •
At night wear the night guard •
Rinse the mouth with 1.5 % solution of chlorhexidine twice a day •
72 hours after surgery the denture must be removed by the dentist and cleaned thoroughly •
During the healing period of approximately 15 days (after the 72 hours) take out the denture only for cleaning •
When indicated by the dentist use Instillagel® or xylocain gel with chlorhexidine during the healing period after the •
first healing period of 72 hours. This gel will give comfort to the patient when the denture is inserted. Apply the gel directly on the anchor sites in the mouth and wait for approximately 1 to 2 minutes.
If the denture comes out put it back immediately •
Use painkillers if necessary during the healing phase. •
geNeRAl
Clean the denture twice a day (using special a denture brush and soap is sufficient) •
After complete healing do not remove the denture for longer than 1 hour •
After the healing period it is recommended to rinse with chlorhexidine once a week •
Always contact your dentist in case of any suspicious changes of the mucosa. •
How to use labels for traceability purposes
.
Opening instructions packaging
1.
2.
3.
4.
5.
6.
7.
8.
9.
© DYNA DENTAL ENGINEERING b.v.
All rights reserved. This manual or any part of it may not be reproduced, stored in a retrieval system, or transmitted in any form or by any mean, electronic, mechanical, photocopying, or otherwise, without prior permission of Dyna Dental Engineering b.v..
